Forget cholesterol – another hidden killer protein may better predict heart attacks, ‘startling’ study suggests

A new study finds that high cholesterol is a less important indicator of heart attack or stroke in women than other subtle signs.

Doctors have long used measurements of cholesterol, a fatty, waxy substance in the blood, as an indicator of possible heart disease.

But a new study of 28,000 American women in their mid-40s finds that cholesterol is not the most important indicator of heart attack or stroke risk.

Instead, high levels of a substance called high-sensitivity C-reactive protein (hsCRP), which is found in large amounts on a blood test, may be a better indicator of dangerous levels of inflammation in the body.

Experts at Brigham and Women’s Hospital in Boston, Massachusetts, found that women with high hsCRP levels have a 70 percent higher risk of having a serious cardiovascular event, such as a heart attack.

A new study of 28,000 American women in their mid-40s suggests that cholesterol is not the biggest indicator of risk for heart disease, one of the biggest killers in Britain.

Results from the Our Future Health project showing levels of high cholesterol in the population based on a sample of 227,592 volunteers. Source: Our Future Health

In comparison, people with higher bad cholesterol levels had only a 36 percent increased risk.

They also tested another factor, lipoprotein(a), a type of fat in the blood that is determined by a person’s genes. They found that high levels were linked to a 33 percent higher risk.

However, experts pointed out that the fact that hsCRP is a stronger indicator of serious heart disease does not mean people should ignore their cholesterol.

Their findings are presented at the European Society of Cardiology Congress in London and published in the New England Journal of MedicineAccording to the authors, women with elevated levels of all three substances had a 2.6-fold increased risk of a major cardiovascular event, such as heart failure.

The results were even more shocking for strokes: Women with elevated levels of the three substances had a 3.7 times higher risk of such a life-threatening event in the next 30 years, compared with women who did not have elevated levels.

The results of the new study were based on blood tests measuring the three factors in women aged 45 who had been followed since 1993.

Julie Buring, an epidemiologist at Brigham and women’s health and a co-author of the new study, said the findings should be a “wake-up call” for both doctors and women.

“Waiting until women are in their 60s and 70s to start heart attack and stroke prevention is a recipe for failure,” she said.

Dr. Paul Ridker, an expert in cardiovascular disease prevention at Brigham and women’s health and lead author of the study, added: “Doctors can’t treat what they don’t measure.”

‘To provide the best care for our patients, we need universal screening for inflammation, cholesterol and lipoprotein(a), and we need it now.

‘In this way, we can tailor our treatments to the specific biological needs of individual patients, fulfilling our long-held desire to provide truly personalized preventive care.’

When doctors talk about bad cholesterol, they are specifically referring to a type of cholesterol called low-density lipoprotein. This type of cholesterol is linked to dangerous fatty deposits around the arteries.

In contrast, “good” cholesterol, technically called high-density lipoprotein, picks up excess cholesterol and carries it to the liver, where it is broken down and removed from the body.

For years, Britons have been advised to keep an eye on their bad cholesterol and reduce the risk of it by eating less fatty foods, exercising more and smoking and drinking less.

Medicines such as statins, a pill taken daily by around 8 million Britons, may also be prescribed to lower cholesterol.

hsCRP levels can rise in response to non-cardiovascular health-related causes of inflammation in the body, such as infection or injury, as well as things like obesity and smoking.

Advice to lower your blood pressure depends on the cause, but it is advisable to improve your cardiovascular health in general, for example by following a healthy diet and exercising regularly.

Some statins have also been found to lower hsCRP levels.

According to the authors, their results support the use of earlier and more aggressive deployment of interventions, both lifestyle changes and medications, to improve cardiovascular health.

Dr Ridker said: ‘While we still need to focus on essential lifestyle factors such as diet, exercise and smoking cessation, the future of prevention will clearly involve combination therapies that target inflammation and Lp(a) in addition to cholesterol.’

Cardiovascular disease is the cause of around a quarter of all deaths in the UK, killing around 170,000 people each year.

That’s about 480 deaths a day, or one every three minutes according to the British Heart Foundation.